Individual
MR. KIRBY IAN POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1747 HERITAGE LN, SUITE B - 103, SYRACUSE, UT 84075-8552
(801) 525-6975
(801) 525-6988
Mailing address
1747 HERITAGE LN, SUITE B - 103, SYRACUSE, UT 84075-8552
(801) 525-6975
(801) 525-6988
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113382-3501
UT
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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